Note : Les descriptions sont présentées dans la langue officielle dans laquelle elles ont été soumises.
CA 02608441 2010-05-13
WIRE GUIDE TORQUE DEVICE
FIELD OF THE INVENTION
[0002] The present invention relates to the field of medical devices, and more
particularly to medical devices for grasping and maneuvering wire guides
during
medical procedures.
BACKGROUND
[0003] Wire guides are used during many medical procedures in the
gastrointestinal system, including the pancreatobiliary system (i.e., the
biliary tree), the
stomach, and the esophagus. During vascular procedures, such as balloon
angioplasty, stent placement, and endoluminal grafts for aortic aneurysms, the
use of
wire guides are essential in assessing the site of the particular obstruction
in the
affected artery. Wire guides are long, slender, relatively flexible wires or
wire-like
elongate devices that are used to gain and maintain access to the body's
narrow
passageways during minimally invasive medical procedures. Because of the
substantial length of wire guides, using wire guides can be cumbersome and
require
constant, delicate manipulation during time-sensitive medical procedures.
[0004] Wire guides often must be maintained in a stationary position relative
to the patient while a physician performs various procedures. In particular,
maintaining
the wire guide in a stationary position is important to prevent loss of access
to a target
anatomy, for example, a duct in the biliary tree. Also, during an esophageal
dilation, a
physician must secure a wire guide within the esophagus and across an
esophageal
stricture as one or more dilators are advanced over the wire guide. Likewise,
during a
percutaneous endoscopic gastromy (PEG) tube placement, a wire guide must be
secured relative to the patient's mouth, esophagus, and stomach as a physician
inserts
a feeding tube.
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[0005] Due to the complexity of these types of procedures, physicians often
need to maneuver the wire guide during medical procedures. However, due to the
difficulty in grasping the wire guide, the task of positioning and maneuvering
the wire
guide generally requires the help of an assistant to grip and manipulate the
wire during
usage. The difficulty associated with positioning and maneuvering the wire
guide,
however, tends to shift the focus of the assistant from their other areas of
responsibility,
such as checking the patient, checking monitors for relevant information, or
carrying out
other tasks.
[0006] As a way of simplifying procedures involving wire guides, devices have
been developed to assist in the positioning and maneuvering of the wire guide
during
medical procedures. One such known wire guide device includes a cylindrical
body and
a slot extending longitudinally for the entire length of the device for side
loading of the
wire guide therein. The device further includes two biased closed jaws on
either side of
the slot and two compression handles for opening the jaws. A problem with this
device
is that when rotating the device for torquing the wire guide, one of the
compression
handles may be pressed inadvertently. As a result, the jaws may separate and
inadvertently release the wire guide. Another problem with this device is that
the slot
extends the entire length of the device. Thus, during use, the smooth,
cylindrical
proximal end of the wire guide may slide out from between the jaws and thereby
exit the
slot of the device.
[0007] Another known device includes pin-vise type wire grips that include a
structure similar to a drill chuck with a cylindrical handle. The chuck is
threaded over
the proximal end of the wire guide and advanced to a desired position. A chuck
collet,
which is a part of the pin-vise, is then rotated to secure the pin-vise to the
wire guide
and serves as a grip to facilitate manual rotation and advancement of the wire
guide.
However, use of this type of device can become time consuming and inconvenient
because of the length of the wire guide and time associated with threading the
device
onto the wire guide, as well as the time associated with tightening the chuck
collet.
[0008] Another known wire guide device utilizes a locking nut portion that
locks onto the wire when turned in one direction and releases when turned in
the
opposite direction thereby requiring the physician to utilize two hands when
locking an
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unlocking the device to the wire guide. Additionally, it may be necessary to
completely
remove and reinsert the wire guide into this type wire guide device during
positioning
and maneuvering of the wire guide. As a consequence, maneuvering of the wire
guide
can become time consuming and distracting to the physician during complicated
medical procedures.
[0009] What is needed is a wire guide torque device that can quickly and
easily engage the wire guide, requires minimal effort to lock and unlock to
the wire
guide during usage, and allows a physician to operate the device using one
hand during
positioning and maneuvering of the wire guide. Also, the wire guide torque
device
should require minimal time and effort to operate during medical procedures.
SUMMARY
[0010] In one aspect of the invention, a wire guide torque device is provided
that comprises a locking mechanism that engages a wire guide so as to allow
the wire
guide to be easily advanced for positioning and maneuvering through a vessel
during
medical procedures. In another aspect of the invention, a wire guide torque
device is
provided that secures to a wire guide at any location along the length of the
wire during
medical procedures.
[0011] ' In a preferred embodiment of the present invention, the wire guide
torque device is comprised of a handle member having a proximal end and a
distal end
wherein a groove extends between the proximal end and the distal end of the
handle
member for inserting a wire guide. A retaining ring is rotatably disposed on
the
proximal end of the handle member for laterally securing the wire guide inside
the
groove along the proximal end of the handle member. A lever is slidably
disposed in
the distal end of the handle member, the lever having a partially depressed
position to
laterally secure the wire guide inside the groove along the distal end of the
handle
member and to allow longitudinal movement of the wire guide in relation to the
handle member. The lever has a released position to longitudinally secure the
wire
guide in relation to the handle member. The wire guide torque device may
include a
pin for securing the lever to the handle member, the pin having a first end
that is
engaged with the lever and a second end that is engaged with the handle
member.
[0012] The wire guide is inserted into the groove of the handle member by
aligning
the retaining ring with the groove of the handle member and by depressing the
lever.
Upon insertion of the wire guide into the handle member the wire guide can be
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advanced along the groove of the handle member. When the lever is depressed,
the
wire guide is free to be maneuvered along the groove of the handle member to a
desired location. When the lever is released, the wire guide is locked into
position in
the groove of the handle member. The lever presses against the wire guide
creating a
frictional force between the groove of the handle member and the wire guide
that is
sufficient to inhibit, limit, and/or prevent the movement of the wire guide
along the
groove of the handle member.
[0012a] In another embodiment there is provided a wire guide torque device,
comprising: a handle member having a proximal end and a distal end wherein a
groove extends between the proximal end and the distal end of the handle
member
for inserting a wire guide. A retaining ring is rotatably disposed on the
proximal end of
the handle member at a proximal end position, the retaining ring rotatable
about the
proximal end position from an open position to a closed position. The closed
position
is configured for laterally securing the wire guide inside the groove along
the proximal
end of the handle member. A lever is slidably disposed in the distal end of
the handle
member for securing the wire guide inside the groove along the distal end of
the
handle member. A biasing member has a first end and a second end wherein the
first
end is in contact with the lever and the second end is in contact with the
handle
member.
[0013] In another aspect of the present invention, there is provided a method
of maneuvering a wire guide. Thus, a wire guide torque device is provided
which
comprises a handle member having a proximal end and a distal end wherein a
groove
extends between the proximal end and the distal end of the handle member for
inserting a wire guide. A retaining ring is also provided which is rotatably
disposed on
the proximal end of the handle member at a proximal end position, the
retaining ring
being rotatable about the proximal end position from an open position to a
closed
position. The closed position is for laterally securing the wire guide inside
the groove
along the proximal end of the handle member. The retaining ring also comprises
a gap
portion. A lever is also provided which is slidably disposed in the distal end
of the
handle member for securing the wire guide inside the groove along the distal
end of
the handle member, the lever also comprising an opening. The retaining ring is
rotated about the proximal end position to align the gap portion with the
groove of
the handle member. The lever is depressed to align the opening with the groove
of
the handle member, and a wire guide is inserted into the groove of the handle
member.
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BRIEF DESCRIPTION OF THE DRAWINGS
[0014] Several embodiments of the present invention will now be described by
way of example with reference to the accompanying drawings, in which:
[0015] FIG. 1 shows a perspective view of a wire guide torque device;
[0016] FIG. 2 shows a partial side view of a handle member of the wire guide
torque device;
[0017] FIG. 3 shows a partial perspective view of the handle member of the
wire guide torque device;
[0018] FIG. 4 shows a partial side view of the handle member of the wire
guide torque device;
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[0019] FIG. 5 shows an end view of one end of the handle member of the wire
guide torque device;
[0020] FIG. 6 shows a side view of a first leg of a lever;
[0021] Fig. 7 shows a perspective view of the lever of the wire guide torque
device;
[0022] FIG. 8 shows a side view of the lever of the wire guide torque device;
[0023] FIG. 9 shows a top view of a second leg of the lever;
[0024] FIG. 10 shows a partial cross-sectional view of the lever in a
depressed configuration;
[0025] FIG. 11 shows a partial cross-sectional view of the lever in a released
configuration;
[0026] FIG. 12 shows a sectional view of a gripping surface of a retaining
ring.
[0027] FIG. 13 shows a perspective view of the retaining ring of the wire
guide
torque device;
[0028] FIG. 14 shows a side view of the retaining ring of the wire guide
torque
device;
[0029] FIG. 15 shows a sectional view of the gripping surface of the retaining
ring of the wire guide torque device;
[0030] FIG. 16 shows a side view of a pin of the wire guide torque device;
[0031] FIG. 17 shows a perspective view of the pin of the wire guide torque
device;
[0032] FIG. 18 shows an end view of an end of the pin of the wire guide
torque device; and
[0033] FIG. 19 shows a perspective view of a biasing member of the lever.
DESCRIPTION OF THE INVENTION
[0034] The invention is described with reference to the drawings in which like
elements are referred to by like numerals. The relationship and functioning of
the
various elements of this invention are better understood by the following
detailed
description. However, the embodiments of this invention are not limited to the
embodiments illustrated in the drawings. It should be understood that the
drawings are
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not to scale and in certain instances details have been omitted, which are not
necessary
for an understanding of the present invention, such as conventional
fabrication and
assembly.
[0035] Referring now to Figure 1, a wire guide torque device 10 of the present
invention is shown. A wire guide torque device 10 includes a handle member 20,
a
retaining ring 30, and a lever 40. The wire guide torque device 10 further
includes a
biasing member 50, such as spring or similar compressed biasing mechanism,
engaged
to the lever 40. The wire guide torque device 10 also includes a pin 60 for
securing the
lever 40 to the handle member 20. The handle member 20 includes a proximal end
22
and a distal end 24 wherein a groove 29 extends between the proximal end 22
and the
distal end 24 of the handle member 20 for inserting a wire guide 12. The
retaining ring
30 is rotatably disposed on the proximal end 22 of the handle member 20 for
securing
the wire guide 12 inside the groove 29 along the proximal end 22 of the handle
member
20. The lever 40 is slidably disposed in the distal end 24 of the handle
member 20 for
securing the wire guide 12 inside the groove 29 along the distal end 24 of the
handle
member 20.
[0036] The wire guide torque device 10 is configured to receive and hold the
wire guide 12, or similar type of elongate medical device (hereinafter
collectively
referred to as a "wire guide"). The wire guide 12 is inserted into the groove
29 of the
wire guide torque device 10 and extends along the length of the handle member
20.
The wire guide 12 can be inserted into the wire guide torque device 10 at any
point
along the body of the wire guide 12 by simply passing the wire guide 12
laterally into or
through the groove 29 of the handle member 20, thereby eliminating the need to
longitudinally insert an end of the wire guide 12 into the groove 29 to engage
the wire
guide 12 to the device 10. The ability of the wire guide 12 to be introduced
at any point
during a medical procedure reduces the associated time of the medical
procedure.
[0037] In the embodiment illustrated in Figures 2-5, the handle member 20 of
the wire guide torque device 10 is elongate and has a cylindrical shape.
However, the
shape of the handle member 20 can include other shapes, such as rectangular,
elliptical, square, or any combination thereof. The optimal length of the
handle member
20 is determined by considering factors such as design and material used, as
well by
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what is determined through experimentation to work best. The proximal end 22
of the
handle member 20 includes a proximal channel 26 for receiving the retaining
ring 30
(FIGS. 12-15). The distal end 24 of the handle member 20 includes a distal
channel 28
for receiving the lever 40 (FIGS 6-9). The handle member 20 may include a
bottom
surface 25 and a top surface 27, wherein the top surface 27 provides an
opening 21 to
receive the biasing member 50 (FIG. 19) engaged between the handle member 20
and
the lever 40.
[0038] The groove 29 of the handle member 20 generally defines a cavity
extending along the entire length of the handle member 20. The groove 29 can
include
a width that is greater than the typical width of a typical wire guide. The
groove 29
secures the wire guide 12 along the path of the handle member 20. The groove
29 is
configured and oriented so as to prevent the wire guide 12 from
unintentionally sliding
out of the handle member 20. When the wire guide 12 is inserted laterally into
or
through the groove 29, the cavity preferably provides a frictional engagement
by
pressing against the wire guide 12 to prevent the flexible wire guide 12 from
inadvertently slipping out of the groove 29. However, the friction provided by
the groove
29 should not be so great as to prevent or inhibit relatively easy insertion
or withdrawal
of the wire guide 12 from the groove 29 of the handle member 20.
[0039] In the embodiment illustrated, the handle member 20 (FIG. 2) can
include a first portion 11 comprising a first diameter D1, a second portion 13
comprising
a second diameter D2, and a third portion 15 comprising a third diameter D3.
The first
diameter D1 may be smaller than the second diameter D2. Additionally, the
second
diameter D2 may be smaller than the third diameter D3. In the embodiment
illustrated,
the second diameter D2 varies and provides a transition between the first
diameter D1
and the third diameter D3. The varying diameter of the handle member 20
enables a
physician to easily grip and operate the device with one hand during
positioning and
maneuvering of the wire guide 12. The third portion 15 of the handle member 20
is
sized and configured to align with the index finger of the user while
adjusting the lever
40 of the handle member 20. Preferably, the size of the varying diameters D1,
D2, D3
of the handle member 20 should be sufficient to facilitate the maneuvering of
the wire
guide or similar medical device. A skilled artisan would appreciate that other
designs
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utilizing different diameter combinations are within the scope of the present
invention.
For example, in an alternative embodiment, the handle member 20 can include a
uniform diameter, such as a first diameter D1, along the entire length of the
handle
member 20.
[0040] The handle member 20 may be preferably formed of molded plastic
material. Alternatively, the handle member 20 and other component parts of the
device
10, such as the retaining ring 30, lever 40, pin 60, and biasing member 50 may
be
formed of any other suitable material, including metal, stainless steel and
nitinol. The
component parts of the wire guide torque device 10 are preferably formed of a
material
which may be repeatedly sterilized by medical providers for re-use during
medical
procedures. Alternatively, the wire guide torque device 10 may be initially
sterilized
following use and then disposed of.
[0041] Figures 6-9 illustrate the lever 40 of the wire guide torque device 10.
As illustrated, the lever 40 preferably includes a first leg 44 and a second
leg 42. The
second leg 42 has an opening 49 for receiving the biasing member 50 (FIG. 19)
for
engaging the lever 40 relative to the handle member 20. The biasing member 50
(FIG.
19) includes a first end 52 and second end 54 wherein the first end 52 is in
contact with
the lever 40 and the second end 54 is in contact with the handle member 20.
The first
leg 44 has an L-shaped groove 48 that is disposed along the midpoint of the
first leg 44.
The first leg 44 also includes a slot 46 at a distal end of the first leg 44.
The L-shaped
groove 48 comprises an entry leg 45 and a locking leg 47. As will be explained
in
greater detail below, the entry leg 45 may be aligned with the groove 29 of
the handle
member 20 to permit insertion or removal of the wire guide 12. The locking leg
47 is
utilized to secure the wire guide 12 against movement relative to the handle
member 20
(FIGS. 10-11). The pin 60 (FIGS. 16-18) includes a first end 62 and a second
end 64
wherein the first end 62 is engaged with the slot 46 of the first leg 44 of
the lever 40 and
the second end 64 is engaged with a slot 25 located on the handle member 20.
[0042] When the lever 40 is depressed the entry leg 45 of the L-shaped
groove 48 is aligned with the groove 29 of the handle member 20 (FIG. 10).
With the
entry leg 45 of the L-shaped groove 48 being aligned with the groove 29 of the
handle
member 20, the wire guide 12 can be inserted into the groove 48 and maneuvered
into
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position. As will be explained in greater detail below, when the lever 40 is
released
(FIG. 11), the biasing member 50 pushes the lever 40 outward to bind the wire
guide 12
between an interior surface of the locking leg 47 of the L-shaped groove 48
and an
interior surface of the handle member 20. The pin 60, which is disposed in
slot 46,
prevents the lever 40 from being completely removed from the handle member 20.
The
lever 40 allows the physician to quickly remove the wire guide 12 from the
wire guide
torque device 10 by simply depressing the lever 40 and sliding the wire guide
12 from
the groove 29. Additionally, a physician is able to quickly reinsert another
wire guide or
reposition the device 10 along the current wire guide 12 without removing the
wire guide
torque device 10. 1
[0043] In a preferred embodiment, the lever 40 operates as a locking
mechanism to secure the wire guide 12 in the groove 29 of the handle member
20. The
biasing member 50, such as spring, curvilinear strut, or similar compressed
mechanism,
engages the lever 40 such that the lever 40 moves between a depressed
configuration
and a released configuration. When the lever 40 is fully depressed, the wire
guide 12
can be removed or inserted in the groove 29 of the handle member 20 (FIG. 10).
When
the lever 40 is partially depressed, the wire guide 12 is free to be
maneuvered
longitudinally along or rotationally within the groove 29 to any desired
location. When
the lever 40 is released, the wire guide 12 is locked into position in the
groove 29 of the
handle member 20 (FIG. 11). The lever 40 presses against the wire guide 12 to
create
a frictional force between the groove 29 of the handle member 20 and the wire
guide 12
that is sufficient to inhibit, limit, and/or prevent the movement of the wire
guide 12 along
the groove 29 of the handle member 20. However, the wire guide 12 is not
damaged by
the wire guide torque device 10. In particular, this configuration avoids
damage to the
wire guide 12, such as stripping, which can result from locking the wire guide
12 within a
wedge or v-shaped slot as in other devices.
[0044] Figures 12-15 illustrate a retaining ring 30 having a first end 32 and
a
second end 34 forming a C-shape defining a gap portion 38 positioned between
the first
end 32 and second end 34 of the retaining ring 30. The retaining ring 30 can
include
slots 35, 37 positioned on the first end 32 and second end 34 of the retaining
ring 30,
respectively. The slots 35, 37 can engage nubs on the handle member 20 to
provide a
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tactile feel and maintain the retaining ring 30 in an alignment position. The
retaining
ring 30 is rotatably coupled to the proximal channel 26 of the handle member
20. The
gap portion 38 of the retaining ring 30 provides an opening for inserting the
wire guide
12 into the groove 29 of the handle member 20. When the retaining ring 30 is
rotated
about the handle member.20 to an open position wherein the gap portion 38 is
aligned
with the groove 29, the wire guide 12 can be inserted or removed from the
groove 29 of
the handle member 20. Conversely, when the retaining ring 30 is rotated about
the
handle member 20 to a closed position wherein the gap portion 38 is misaligned
with
the groove 29, the wire guide 12 is prevented from being removed from the
groove 29 of
the handle member 20. The retaining ring 30 of the wire guide torque device 10
allows
the wire guide 12 to be quickly inserted and removed from the device at any
location
along the wire guide 12 during medical procedures.
[0045] The retaining ring 30 includes a gripping surface 36 for providing
torque when rotating the retaining ring 30 about the axis of the handle member
20.
Additionally, the gripping surface 36 can be provided along the surface of the
handle
member 20 to allow the user to properly grip the handle member 20 and apply
torque
during manipulation and repositioning of the wire guide 12 during medical
procedures.
The gripping surface 36 further provides a frictional surface for grasping the
device 10
during medical procedures wherein the device may be exposed to bodily fluids.
In
another embodiment, the wire torque guide device 10 can include at least two
retaining
rings 30 for securing the wire guide 12 wherein the second retaining ring is
positioned
along the length of the handle member 20. In an alternate embodiment of the
present
invention, the retaining ring 30 can comprise a length that extends along a
substantial
portion of the handle member 20. The length of the retaining ring 30 may vary
depending on the shape and particular design of the wire guide device 10 and
fall within
the scope of the present invention. For example, instead of including a
retaining ring 30
having a ring shape disposed along the proximal end 22 of the handle member
20, the
retaining ring 30 can include a spherical shape, such as a sleeve, extending
between
the proximal end 22 and distal end 24 of the handle member 20, or any portion
thereof.
[0046] Figures 16-18 illustrate the pin 60 for securing the lever 40 to the
handle member 20. The pin 60 preferably has a cylindrical shape for engaging
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of the handle member 20. In other embodiments, the pin 60 can include other
shapes,
such as rectangular, elliptical, square, or any combination thereof. Figure 19
illustrates
the biasing member 50, which engages the lever 40 thereby allowing the lever
40 to
revert to a released position after being partially or fully depressed.
[0047] The wire guide torque device 10 may also comprise a coating 33 (see
FIG. 1) to facilitate grasping and maneuvering of the wire guide torque device
10 during
a medical procedure. The coating 33 may be applied to the entire composite
structure
of the wire guide torque device 10 or singly to specific components, such as
the handle
member 20, retaining ring 30, lever 40 or any combination thereof. The coating
may be
applied by dipping, molding, or spraying a suitable material, such as
polytetraflouroethylene, urethane, and /or other polymeric coatings, directly
to the wire
guide torque device 10.
[0048] The coating 33 may be applied by heat shrinking a heat shrinkable
material about the desired portions of the wire guide torque device 10. In
preferred
embodiments, the thickness of the coating 33 is between approximately 2.5
micrometers and 2.5 millimeters. In some embodiments, the thickness of the
coating 33
is between approximately 2.5 micrometers and 100 micrometers. In other
embodiments, the thickness of the coating 33 can be between approximately 2.5
micrometers and 50 micrometers. These preferred thicknesses provide suitable
coatings while not adding significantly to the overall thickness of the device
10. One of
ordinary skill in the art would appreciate that the amount and thickness of
the coating 33
is related to the length, width and material of the coating 33. Additionally,
a wire guide
torque device 10 without a coating 33 is within the scope of the present
invention.
[0049] The above figures and disclosures are intended to be illustrative and
not exhaustive. This description will suggest many variations and alternatives
to one of
ordinary skill in the art. All such variations and alternatives are intended
to be
encompassed within the scope of the attached claims. Those familiar with the
art may
recognized other equivalents to the specific embodiments described herein
which
equivalents are also intended to encompass by the attached claims. Moreover,
the use
of this invention on a wire guide is not a limitation of the claims. Use of
this device with
other tubing and elongate medical devices used in medical procedures and the
like is
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understood to be within the scope of the claims.
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